Stiff-person syndrome associated with multiple myeloma following autologous bone marrow transplantation.
Stiff-person syndrome (SPS) is an immunologically mediated central nervous system disorder that is infrequently associated with malignancy. We report a 31-year-old woman who developed SPS after autologous bone marrow transplantation and subsequent interferon treatment for multiple myeloma. Anti-glutamic acid decarboxylase (anti-GAD) antibody serology was positive. The myeloma remains in remission 10 years posttransplant. SPS has been described in association with lung cancer and breast cancer, thymoma, and Hodgkin lymphoma. This is the second report of SPS in a patient with myeloma and the first description of SPS following autologous transplantation. Aberrant immune reconstitution is known to occur following hematopoietic progenitor cell transplantation. Interferon is also known to augment the immune response posttransplant. We speculate that an aberrant posttransplant immune response may have caused both the SPS and an autologous graft-versus-myeloma effect, resulting in prolonged remission posttransplant.
Clow
Erin C
EC
Department of Medicine, Dalhousie University, Halifax, Nova Scotia B3H 3A7, Canada.
Couban
Stephen
S
Grant
Ian A
IA
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D004576:Electromyography; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D009101:Multiple Myeloma / Q000150:complications*; D010954:Plasmacytoma / Q000150:complications / Q000473:pathology; D016750:Stiff-Person Syndrome / Q000150:complications* / Q000209:etiology*; D014182:Transplantation, Autologous
D016756:Immunoglobulins, Intravenous